Internal Fixation of Complicated Acetabular Fractures Directed by Preoperative Surgery with 3D Printing Models

Abstract

The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed. A 3D printing pelvic model was established using CT digital imaging and communications in medicine (DICOM) data preoperatively, with which surgical procedures were simulated in preoperative surgery to confirm the sequence of the reduction and fixation as well as the position and length of the implants. Open reduction with internal fixation (ORIF) of the acetabular fracture using modified ilioinguinal and Kocher-Langenbeck approaches was performed 25 days after injury. Plates that had been pre-bent in the preoperative surgery were positioned and screws were tightened in the directions determined in the preoperative planning following satisfactory reduction. The duration of the operation was 170 min and blood loss was 900 mL. Postoperative X-rays showed that anatomical reduction of the acetabulum was achieved and the hip joint was congruous. The position and length of the implants were not different when compared with those in preoperative surgery on 3D printing models. We believe that preoperative surgery using 3D printing models is beneficial for confirming the reduction and fixation sequence, determining the reduction quality, shortening the operative time, minimizing preoperative difficulties, and predicting the prognosis for complicated fractures of acetabulam.

Three-dimensional printing simulated operation combined with robot-aided minimally invasive lumbopelvic fixation in treatment of unstable bilateral sacral fractures: technical notes and 8 case series

“…Koshimune [28] compared conventional open lumbopelvic fixation with minimally invasive procedure for unstable Preoperative planning is always essential for complicated injuries, especially pelvic and acetabular fractures. Recently, it has been shown that the preoperative planning of complicated fractures can be improved more effectively with 3D printing technology [13,14] . In view of our experience about this group of cases, we summarize advantages with 3D printing model as follow.…”

“…Existing studies show that the surgical treatment of acetabular or pelvic fracture was completed more effectively by surgeons who took advantage of 3D printing technology [13][14] . In addition to patientspecific 3D printing external template [15] , there is no doubt that the biggest advantage lies in the use of equal proportion printing model for simulated operation, which can confirm the ideal sequence of fracture reduction and fixation or the osteotomy site, and determine the optimal position of the implants.…”

Application of 3D‐printed Customized Guides in Subtalar Joint Arthrodesis

“…3D printing technology has brought new hope for achieving precise drilling of Kirschner wires. The application of 3D printing technology in orthopaedic surgery is developing rapidly and has been successfully used in many medical fields, such as for clearer 3D demonstration of disease and operation plans for doctor–patient communication; for preparation of a large amount of customized casts and insoles; manufacture of guides that are highly matched with the anatomy of the patient, which facilitates the positioning of implants and reduces the operation time; and printing of customized metal implants to improve operative outcomes. To prepare the customized guides, we need to first collect the CT data of the patient to conduct the 3D image reconstruction.…”

Personalized Three‐Dimensional Printed Anterior Titanium Plate to Treat Double‐Column Acetabular Fractures: A Retrospective Case‐Control Study

“…Three-dimensional (3D) printing technologies have attracted increasing interest in medicine, with various applications in the orthopaedic field. 3D printing is applied in many areas in orthopaedics, ranging from production of customized surgical tools and prostheses, implants and internal fixations to operative rehearsal and visualization of complex surgical procedures [5][6] . To tackle the problems mentioned with the DAPSQ reconstruction plate, we have used personalized 3D printed DAPSQ plates to fix complex acetabular fractures since 2014 [7][8] .…”